Presence of left ventricular contractile reserve, evaluated by means of dobutamine stress-echo test, is able to predict response to cardiac resynchronization therapy

J Interv Card Electrophysiol. 2008 Nov;23(2):121-6. doi: 10.1007/s10840-008-9255-9. Epub 2008 Jun 28.


Introduction: We evaluated whether the dobutamine stress-echo test can select responders to cardiac resynchronization therapy (CRT). Up to 50% of patients do not respond to CRT. Lack of response may be due to a significant amount of scar or fibrotic tissue at myocardial level.

Methods and results: We studied 42 CRT patients. After clinical and echocardiographic evaluation, all patients underwent a dobutamine stress-echo test to assess contractile reserve. Cut-off for the test was an increase of 25% of the left ventricular ejection fraction. Patients were implanted with a CRT-defibrillator and followed up at 6 months. Cut-off for CRT response was a reduction of 15% of left ventricular end-systolic volume. Twenty-five patients responded to CRT; all of them showed presence of contractile reserve. The test showed a sensitivity of 100% and a specificity of 88%.

Conclusion: Contractile reserve was a strong predictive factor of response to CRT in the studied population.

MeSH terms

  • Aged
  • Cardiac Pacing, Artificial*
  • Cardiotonic Agents*
  • Chi-Square Distribution
  • Dobutamine*
  • Echocardiography, Stress
  • Female
  • Humans
  • Male
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Statistics, Nonparametric
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Dysfunction, Left / therapy


  • Cardiotonic Agents
  • Dobutamine